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Lady health workers’ issue may ignite more protests

KARACHI: The indecisiveness of the federal and provincial governments towards the continuation or regularisation of services of over 24,000 lady health workers (LHWs) and supervisors may ignite a fresh wave of protests in the days to come, warned senior officials in the Sindh health department.

Though the health department had survived a protest campaign launched last month by the LHWs, who had been engaged by the federal government in the province due to the intervention and personal interest of the chief minister, the LHWs may revive their campaign in future, said a source privy to the family planning and primary health activities.

The LHWs leaders in their protest campaign had threatened to boycott the polio-immunisation activities if something concrete was not done in the matter of non-payment of their stipends and regularisation of their services.

At present about 23,000 LHWs are engaged under a federal government project “Family Planning and Primary Health (FP&PH)” and get a stipend of Rs7,000 each under a contract system, which in line with a PC-1 could be continued till the end of the current financial year.

While the LHWs wanted to ascertain their future, the federal health ministry was unwilling to get involved in any new expenditures and obligations for the cadre in question.

It is learnt that the chief minister in a letter to the federal government had stressed the need for an immediate payment of the accumulated monthly stipend to them and steps for the regularisation of their jobs.

A cadre of LHWs was established at the grass-roots level in 1994 to ensure health education, reproductive health, vaccination, control of diarrhoea and other communicable diseases, promotion of using safe water and sanitation facilities and other dimensions of primary healthcare in rural areas.

They were being paid Rs3,000 per month as stipend on a quarterly basis till August, 2010. However, the amount was increased to Rs7,000 following a verdict of the Supreme Court of Pakistan last year and thus the financial implications were also increased and the health ministry had to take extra measures in this regard, said the source related to the LHWs services.

Sources said that in addition to the logistic and training cost, the one-month payment to LHWs and their supervisors amounts to Rs165 million.

The provincial coordinator for the family planning and primary health programme in Sindh, Dr Firoze Memon, told Dawn that following the release of Rs191 million, the salaries for the months up to December, 2010, had recently been transferred to the bank accounts of LHWs and their supervisors.

“The federal government has also intimated more release of funds shortly, which will enable us to pay salaries for the months of January and February, 2011, to all the LHWs and supervisors in the province,” the coordinator added.

The sources said that there were many issues that needed to be addressed on a priority basis for the sake of public health, but Islamabad was very much confused on the lady health workers issues, particularly after the passage of the 18th Constitution Amendment and the government decision to devolve the health sector to provinces by the end of June. A reply of a special letter sent to Islamabad, after a meeting with the LHWs’ leaders on January 31, was still awaited, they added.

It is learnt that some provinces had been convincing the federal government to ensure its financial supports against various ongoing projects in the province for at least another three years after the transfer of the health initiatives and schemes to the provinces, if the Centre wanted to see any purposeful continuity of those projects.

A source in the health department said that senior officials at a meeting held at Islamabad recently had also expressed their inability to fund the federal government-funded projects, particularly at a time when the province already needed to re-launch its various health facilities and restore its infrastructures that had been destroying in the floods.

Sindh wanted the federal funding to continue at least for the next five years, following which it would reassess the situation and decide a new line of action, the source added.

Commenting on the status of the LHWs, a senior official, requesting anonymity, maintained that the utility of the lady health workers in the existing health care delivery and education and awareness systems could hardly be denied.

However, no matter the federal government granted them the status of regular government employees or not, the Sindh government, after devolution, would have to decide their fate and regularise them, without taking into account the huge financial burden it would have to bear, otherwise the protest campaigns against the government would continue with all intensity, the official remarked.

Source: Dawn